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H. Pyo
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P2.05 - Poster Session with Presenters Present (ID 463)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Radiotherapy
- Presentations: 1
- Moderators:
- Coordinates: 12/06/2016, 14:30 - 15:45, Hall B (Poster Area)
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P2.05-022 - Is Post-Chemotherapy Tumor Volume Sufficient RT Target Volume in Patients with LD-SCLC? (ID 6282)
14:30 - 14:30 | Author(s): H. Pyo
- Abstract
Background:
This study was conducted to investigate the pattern of intrathoracic failure regarding the radiotherapy (RT) target volume in patients receiving early or late thoracic RT for limited-disease small cell lung cancer (LD-SCLC).
Methods:
One hundred ten patients who were enrolled in previous randomized trial of concurrent TRT with either first cycle (early TRT) or third cycle (late TRT) of chemotherapy were analyzed. RT target volume was based on initial tumor volume in early TRT group, and post-chemotherapy tumor volume in late TRT group. Initially involved nodal regions were covered in late TRT group, whereas uninvolved nodal regions were not included electively. TRT dose was 52.5 Gy in 25 fractions per daily. Prophylactic cranial irradiation (PCI, 25 Gy in 10 fractions) was delivered to 79 (71.8%) patients who had complete response or very good partial response. We analyzed pattern of failure regarding TRT target volume.
Results:
Median follow-up duration was 28.5 months. Overall recurrence rate is 69.1% (n=76). Intrathoracic (locoregional) failure with or without distant metastasis was developed in 27.3% (n=30). Distant metastasis including brain metastasis was observed in 46.8% (n=46). Among early TRT group (n=56), 14 patients (25.0%) had intrathoracic failure; 13 within initial tumor volume, and one on the boundary of initial tumor volume. Among late TRT group (n=54), 16 patients (29.6%) showed intrathoracic failure; 15 within post-chemotherapy tumor volume and one on the boundary of initial tumor volume. There was no regional recurrence outside target volume in both groups. There were 30 patients who developed brain metastasis. Patients who receive PCI showed brain metastasis less frequently (n=19/79, 24.1%) than patients who did not receive PCI (n=11/31, 35.5%, p=0.033).
Conclusion:
Using post-chemotherapy tumor volume is feasible strategy in determination of TRT volume in patients with LD-SCLC. Development of new RT dose fractionation schedule to further improve in-field local control may be warranted.
